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Managing Rheumatoid Arthritis Through Dietary Approaches

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Diet modification can help in managing a number of conditions like rheumatoid arthritis.

Medically reviewed by

Dr. Kaushal Bhavsar

Published At November 24, 2023
Reviewed AtNovember 24, 2023

Introduction

Studies show that patients with rheumatoid arthritis spend over a million dollars annually experimenting with unproven treatments. A study conducted in 1989 by Arthritis Care revealed that more than half the people with rheumatoid arthritis had spent money on unorthodox medicines, substances, or treatments (including diets) during the prior six months. Studies have been conducted since the 1930s to find the link between arthritis and diet.

What Is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease that causes severe acute inflammation. It affects around one percent of people across the whole world. Due to the higher morbidity and shorter life expectancy it causes, the condition has negatively impacted the quality of life. Most frequently, bilateral involvement affects the hands, wrists, and knees, resulting in swelling, discomfort, and eventually irreversible joint degeneration. Risk may be attributed partially to genetic factors, to environmental factors, or a combination of environmental and genetic factors. Tobacco smoking, infectious diseases, and gut microbiota have all been implicated in the onset or development of the condition.

How Are Rheumatoid Arthritis and Diet Linked?

Patients with rheumatoid arthritis typically report symptoms related to their gastrointestinal tract, like mucosal ulcers, abnormal bowel habits including constipation or diarrhea, and dyspepsia (symptoms of indigestion like bloating, fullness, nausea, early satiety, epigastric pain, and burning and belching). All studies show that a shift in the gut microbiota has been linked to the development of rheumatoid arthritis. The ‘gut-joint axis’ theory applies to human rheumatic disorders and may contribute to the pathophysiology of rheumatoid arthritis, according to recent findings from the Littman laboratory. Their studies found that Prevotella copri is substantially more common in rheumatoid arthritis patients than in healthy controls. The gut-joint axis theory states that elevated zonulin (a protein produced in the intestine and liver cells that manage intestinal permeability) synthesis is the primary mechanism responsible for intestinal barrier disruption in rheumatoid arthritis.

What Dietary Interventions Can Help Managing RA?

Diets alone cannot cure the condition. However, certain dietary modifications can help reduce inflammation (which is bad for the body), provide the necessary nourishment, and maintain a healthy weight. This is another important factor because being overweight increases the load on the sore joints, reducing the effect of the medicines taken. Moreover, cytokines, a protein produced by the body fat, can worsen inflammation. Research shows that a Mediterranean diet, which includes whole grains, fruits, vegetables, and healthy fats, can be beneficial to those with rheumatoid arthritis. Some foods that can be included in their diet include:

  • Fatty Fishes: Omega-3 fatty acids, abundant in cold-water fish like salmon, tuna, sardines, herring, and others, may help reduce inflammation. Omega-3 and Omega-6 fatty acids must be in a healthy balance for the well-being of the body. Studies have shown that an increased risk of chronic inflammatory disorders like rheumatoid arthritis is linked to a higher ratio of Omega-6s to Omega-3s. As a result, it is critical to boost Omega-3s and decrease Omega-6s, which can cause inflammation and are present in meats, some oils, and fried and processed foods.

  • Fruits and Vegetables: Fruits and vegetables are rich in antioxidants. They aid in the stabilization of chemicals known as free radicals. Free radicals have the potential to cause inflammation and cell damage. Fruits and vegetables are also a great source of polyphenols, vitamins, and minerals that the body requires, all of which may help reduce the inflammatory marker C-reactive protein (CRP). However, fruits and vegetables must be consumed while considering their sugar content. To acquire the most nutrients, eat a colorful range of vegetables. Two cups of fruits and three and a half cups of vegetables are advisable for a person with 30 minutes of exercise regularly to maintain a healthy body.

  • Whole Grains: Whole grains such as quinoa, brown rice, oats, and whole wheat may help lower CRP levels and the risk of heart disease, which is more common in RA patients. Refined grains lack the fiber and mineral content of whole grains. Moreover, they may also have unhealthy additives like sugar and saturated fats.

  • Legumes: Patients with rheumatoid arthritis are more likely to lose muscle mass and hence require a lot of proteins in their diets. This is available in abundance in legumes like peas and beans. In addition, they are almost fat-free, have antioxidants, and are rich in potassium, magnesium, iron, zinc, folic acid, and other nutrients that are good for heart health and the immune system.

  • Nuts: Nuts are known for their essential nutrients and properties to protect the heart. In addition, they are a rich source of monounsaturated fats. Walnuts and flaxseeds are abundant sources of Omega-3 fatty acids and benefit those with rheumatoid arthritis. However, nuts should be consumed cautiously, as they are high in calories and fats.

  • Olive Oil: Olive oil contains good monounsaturated fats, as well as Oleocanthal, a substance that lowers inflammation and relieves pain. This can be beneficial in reducing inflammation and sore joints.

What Food Should Be Avoided or Limited In RA?

While considering food that lowers inflammation, care should be taken to avoid or limit food that worsens inflammation. These are called pro-inflammatory foods. They can include:

  • Processed carbohydrates like refined flour, white sugar, etc.

  • Foods rich in saturated fats, like fried foods.

  • Red meat.

  • Processed meats.

  • Dairy.

  • Egg.

  • Salt intake.

If these food items cannot be avoided entirely, their use must be limited. Small changes in diet can do wonders to reduce inflammation in rheumatoid arthritis.

Conclusion

Rheumatoid arthritis is a type of autoimmune condition. It can be eased by making small changes in diet. Several long-term rheumatoid arthritis patients have claimed that eating particular food either makes their symptoms better or worse. Supplemental foods such as multivitamins, cod liver oil, and vitamin D can also aid in managing RA. By including these foods in the daily diet, joint damage may be decreased, and disease activity and progression may be delayed. However, it must be considered that modifying diet alone might not help manage arthritis. Appropriate and timely medical care is also essential for symptom management.

Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)

Tags:

diet therapyrheumatoid arthritis
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